It’s complicated – that’s what you hear a lot from people trying to deal with the aged care system in Australia.  There seems to be so much information to take in, it can be overwhelming.  

If it is early days for you or a loved one, venturing into the world of possibilities with getting some help at home, our beginner’s guide will show you the broad lay of the land, what’s most important to know and where to start.

How does home care work in Australia? 

Anyone can pay for someone to come to their home to help them with chores or run them to appointments, but what we are talking about are support services that are subsidised by the Commonwealth Government.   There are two government programs that provide subsidised services for people in their homes, depending on their needs and situation.  

The Commonwealth Home Support Program (CHSP) provides more ‘entry-level’ support. It is for people who are living independently at home, managing fairly well, who might need only one or two services to ensure they stay independent.  The CHSP is the biggest aged care program in Australia. 

Home Care Packages (HCPs) are designed for people who need more than just the one or two services.  HCPs are for people who have more complex care and support needs and would benefit from a more coordinated approach.  There are four different ‘levels’ of Home Care Package that provide different amounts of funding, depending on the amount of support you need. HCPs are the fastest growing area of the aged care system.  At 31 March 2021, 183,376 people had access to a Home Care Package though many didn’t have packages at the level they needed and, as the media has reported widely, there remain long waiting lists.

How do you know which services you can get?

You can’t just choose the program or the services you think you need – you have to have an assessment by trained experts.  That means getting in touch with the government’s My Aged Care hub*.  There are two steps involved in the assessment.  

Getting assessed for home care

Contact My Aged Care

Firstly, you need to provide some top-line information about the reasons you (or the person you are representing) are applying and the kinds of needs you have.  You can do it online or you can call the 1800 number and speak to someone directly:  1800 200 422. 

Prepare for your Face to Face assessment

The second step in the process is a face to face assessment that happens in your home.   There are two types of face to face assessment and the one you have will be decided based on the information you gave in step 1.

So, you’re doing OK?

If in step 1 it sounds like you need only low-level support, you will probably have your face to face assessment with a Regional Assessment Service (RAS) assessor, that is connected with the Commonwealth Home Support Programme (CHSP) – the program that provides ‘entry-level’ support. 

Maybe you need a little more help?

If in step 1 it sounds like you need more than entry level support, you will be referred to have a comprehensive face-to-face assessment with an Aged Care Assessment Team (commonly referred to as an ‘A-CAT’).  The ACAT assessment will determine what ‘level’ of Home Care Package you are eligible for (there are four levels) and also whether you are eligible for other care options, including residential aged care.  

How much money will you have to get the help you need? 

The amount of funding you have depends on the level of HCP you’re eligible for. That’s what the assessors determine when they do the face to face assessment with you.  Depending on your assessed level of need, you could be eligible for any of four different levels of Home Care Packages (HCP):

• Level 1 Basic care needs – approximately $9,000 a year
• Level 2 Low care needs – approximately $15,750 a year
• Level 3 Intermediate care needs – approximately $34,250 a year
• Level 4 High care needs – approximately $52,000 a year 

Of course, the amounts are frequently reviewed to keep pace with the changing cost of living.

What kinds of help can you get with your HCP?

You can get a lot of different ‘types’ of subsidised support services and products with a Home Care Package, including:

• services to keep you well and independent – think personal care (dressing, showering etc), nursing services, allied health (physiotherapy, podiatry, occupational therapy etc).
• services to keep you safe in your home – including cleaning, laundry, home maintenance and modifications, ‘assistive technology’ (devices that assist mobility, communication and personal safety)
• services to keep you connected to your community – including transport, shopping, keeping up social connections.

You can’t use your HCP to pay a mortgage or rent, grocery bills or other general costs of living.

Who holds the money? 

Not you.  While the money is allocated to you personally, you don’t get it paid into your bank account.  Once you are told you have been allocated a HCP, you need to choose a HCP provider that will ‘host’ or ‘hold’ your HCP funding on your behalf. They’ll pay the bills and provide you with a monthly statement on your income and expenditure, based on the services you receive.  You can search HCP providers via the ‘Find a Provider’ search tool on the My Aged Care website.

HCP Provider vs Service Provider – know the difference.

The HCP provider holds the funds while a service provider is an organisation or individual that provides a service.  Most HCP providers are also service providers, which means they have their own staff who can deliver care and support services.   You can choose to get your services from your HCP provider if you want but you don’t have to (see ‘Know your choices in managing your HCP’ below).  You can choose to receive your support services from a different service provider organisation or from multiple service providers organisations or individuals.

What and who are Service Providers?

Service providers are often qualified health care workers like nurses, physiotherapists or occupational therapists; but they are also general support workers who can help you do your laundry, your grocery shopping or clean your house.

How much control do you have over your HCP?

While your HCP funding is held by your HCP provider, you can choose a range of ways to be involved in how your package is managed.  At one end of the spectrum, your HCP provider can manage the package and make all the decisions entirely on your behalf – to work out what you need, allocate your support workers and manage your schedule.  At the other end, you can opt to employ your own support workers and manage the schedule yourself.  You can also negotiate a combined approach where you might self-manage some things and have other things managed for you.   Many people choose to manage some things themselves to save on administration fees and get more support hours from their package. 

Traditionally HCP providers always managed the package on behalf of their clients with varying degrees of involvement and direction on the part of the client.  When it became law in 2017 to offer ‘consumer directed care’ for all HCPs, it was not mandatory for all HCP providers to offer full self-management.  So, if you want to self-manage your HCP, you may need to raise the subject with your prospective HCP provider.  And you may need to shop around.  

What do you have to pay?

Most people, when they are allocated a HCP, will be asked to pay a ‘basic daily fee’ or ‘care recipient contribution’, which is set by the government at a percentage of the Age Pension.  Depending on your assessable income, you might also be asked to pay an income tested care fee.  Depending on the HCP provider and what you agree to, you might choose to pay for other things too; but these are up to you.  

Choosing self-management

For people who want to try self-management – even a little – Mable helps you connect with care and support workers in your community and choose the people who share your interests and suit your needs best. Learn more about Self-Managing your home care package here.